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The Cancer Moonshot At A Crossroads: Will The Next President Commit To The Effort To End Cancer?

During a time of seemingly unprecedented divisions in our nation, the Moonshot has united us in a cause far larger than any one of us. If it ends as fast as it began, we will have far more to mourn than another shuttered government program.
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The clock is ticking towards what could be the end of the popular Cancer Moonshot.

On January 20, its two biggest proponents, the President of the United States and the man who has stirred the nation's conscience in the fight against cancer, Vice President Joe Biden, leave office.

With them goes the presidential bully pulpit, the resources, and the implicit backing of two of the most powerful and influential leaders in the world.

Just six months left on what should rank near the top of everyone's national priorities list. After all, cancer accounts for one in every four deaths in the world. It will claim not just some 600,000 Americans this year, but over eight million people around the globe. And lung cancer is by far the deadliest, with the U.S. Centers for Disease Control and Prevention (CDC) reporting roughly 1.6 million lives lost in 2012 - more than double the victims claimed by the number two killer, liver cancer.

Six months. That's a blip. But conversely, consider what Biden, and his hand-picked Moonshot director Greg Simon, have achieved in just seven months since the president announced the modern-day war on cancer in his 2016 State of the Union address to the nation.

The scientific community has diverse opinions on achieving the goals that Biden and Simon have established and how the army of cancer-fighting forces will get there. But most agree, certainly those who know Washington, that what they have done in such a short time, particularly when the political process in our nation is so polarized, is nothing short of phenomenal. In seven months, the vice president has managed to inspire a good many Americans, and with Simon, corral a national industry of ambitious, competitive and stove-piped researchers and their personal initiates into a living, breathing organization that exudes hope and excitement that ending cancer, or making it a manageable disease in the next decade is achievable.

So far, the Moonshot is off to a terrific start. Whether there is enough momentum to make it a priority in the next administration is open to debate. President Richard Nixon first called Americans to fight a "War on Cancer" in 1971. And while we've made considerable progress since then - Nixon's war stalled over the years. Biden, full of empathy and understanding for those and their loved ones who struggle and loose their lives to cancer, like his own son, reminded all of us that we can now win this war - but to do so we need big ideas that a unified nation of great minds can produce.

There is still much to be done on the Moonshot. Rallying around ideas, big and small, is the right approach. That was the spirit of the vice president's recent Moonshot Summit in Washington, D.C., where a group of several hundred eclectic thinkers, researchers and patients gathered to discuss strategies and tools, from photonic laser research to the latest in immunotherapy.

My turn to share my big idea came in a small meeting with Biden and Simon. Most big ideas usually contain a measure of common sense, with solutions so obvious if we only looked at the problem differently.

One such example, I told the vice president, lies in access to bio-specimens and patient data. Bio-specimens hold the answer to many unanswered questions on the biology of the disease. Yet a good portion of them, mostly at community hospitals, are lost to researchers. Approximately 80 percent of all cancer patients are treated in community hospitals and clinics. Yet the specimens used for pathology are typically discarded. This is a surprising and easily fixed roadblock. The solution is to store these specimens in a centralized open-source, open-access biorepository managed by experienced brokers with no vested interests other than advancing the state of the science and accelerating the search for cures to help patients today.

This centralized biorepository would host bio-specimens from all cancer patients that are well annotated with clinical, pathologic, demographic and outcomes data, and can be a resource to anyone in the field willing to ask critical questions that address unmet medical needs.

Collecting samples from community hospitals will leverage the power of the information age to address questions on each individual molecular subtype of cancer as we move into the era of precision medicine (matching the right treatment to the right patient, at the right time) and each slice of the cancer pie becomes smaller and smaller. This could be the most prominent biorepository in the world. Making these bio-and data-repositories 'open-source' and 'open-access' will break down the silos that impede research that can impact cancer patients lives' today, and those of cancer patients of tomorrow.

Biden was genuinely intrigued by the idea and I could see he was surprised that nothing like this already existed. And it's anybody's guess whether those who seek to replace this administration would embrace this idea and the other very good ones that Biden and Simon have encouraged among cancer thinkers.

Both candidates have spoken generally but not authoritatively about health care. Absent from their platforms is any language that supports the Moonshot. The next president may be dismayed by funding the initiative, as limited as the $1 billion budget is. But perhaps they could appeal to our fellow Americans, millions who will in some way be touched by cancer. Why not ask every American to make a $10 commitment to a respected organization involved in defeating cancer. Perhaps it's as easy as changing an IRS code to make such a donation deductible when filing annual income tax returns. Not only would it raise more then a billion dollars, it would invite all Americans to join the Moonshot.

Like a diagnosis of cancer, the time remaining for the Moonshot is uncertain. All of our eyes should be on that ticking clock. During a time of seemingly unprecedented divisions in our nation, the Moonshot has united us in a cause far larger than any one of us. If it ends as fast as it began, we will have far more to mourn than another shuttered government program.